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The Journey of Self-Awareness

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Who carries the responsibility of teaching us how to communicate effectively and display emotional intelligence? Is there a responsibility to teach it, or do some people naturally acquire this skill? As healthcare workers, we are considered courageous, brave, and able to connect easily with people. But I have a vague memory of studying a communication paper I read early in my nursing degree. This vagueness is not a reflection on the paper itself but more on the lack of importance I placed on the subject at the time.

My view of emergency nursing as a junior some fifteen years ago was that I was very task-focused. Sending people home and getting through my jobs as quickly as possible seemed of utmost importance. To-do lists completed and everything up to date. All the boxes ticked. I wanted to be a nurse that worked hard and was a team player. I wanted to be on the ball, catching patients before they deteriorated. I wanted to be on the go, reactive and fast.

Now, through a more veteran lens, I see things a little differently. Those tasks are still important (mostly). But now I feel that other things have a higher priority. Is this person distressed? Do they need emotional support? Is there a challenging conversation that no one is brave enough to have? Who is parenting these parents? Who are their supporters? When did these parents last eat?

When there are stories of aggression, I wonder, “Have we communicated their patient journey effectively? Who has sat with them and explored this anger so they feel heard?” The advice of the late Dr Richard Aickin is often in my ears, “Spend a little time now to save a lot of time later.” You cannot reach the place of courage to have these difficult conversations without first being vulnerable.

There is a correlation between emotional intelligence and the safety of practice. Emotional intelligence is the ability to perceive your emotions and those of others. Emotional intelligence in healthcare workers gives patients a more satisfying experience and improves their care. Daniel Goleman’s emotional intelligence theory describes the domains of emotional intelligence as self-awareness, self-regulation, motivation, empathy and social skills.

Being courageous enough to notice is contagious. Although at times it may involve heartbreak and failure, it is important to continue to try even when you cannot control the outcome. To feel is to be vulnerable. It may feel easier to “armour up” but we are human. To feel is to be human. Never underestimate the power of sitting in the rubble with someone and asking them what is going on. Active listening is a powerful diffuser. Being curious, non-judgmental, and genuinely wanting to hear their story can guide a conversation in directions you never imagined. You can never assume why someone has or has not done something. By remaining curious it shows that it is okay to be vulnerable, giving over to uncertainty.

Incivility significantly decreases performance. For effective learning conversations to occur, they need to be partnered with learner well-being in an environment safe for interpersonal risk-taking. This means exploring new ways of talking or acting are not ridiculed. It creates that feeling of safety such that any mistakes will be explored together rather than being responded to with punishment. It takes emotional intelligence to create this feeling of psychological safety.

Individuals cannot fix the healthcare system. We work in challenging circumstances. But what if, on each shift, we all do one small thing for one person? Noticing that a parent has not eaten all day, asking caregivers and patients if they are okay, checking in with your colleagues after a resuscitation and advocating for a debrief. This is not ground-breaking work. But it may be to that person at that moment. Do not underestimate the power of simple things. One simple act may give the receiver the strength to care for others. Or it might provide some small comfort in the knowledge that their suffering has been seen. Knowing what psychological safety means and attempting to infuse this throughout our clinical practice can have a profound impact. Empathy is connecting an experience to the emotion underneath. Are you willing to start small and try it? Do not be too hard on yourself. The journey begins with self-awareness. The learning never ends. We all have days where we do not get it right. Everyone has a shadow self that presents itself now and then. The key is to acknowledge it, apologise if necessary, and grow. Do not be afraid if you have had tough life experiences. Where the cracks of life happen is where the light comes in. Those who know pain have much to give others experiencing something similar in moments of despair.

Allow your experiences to rise and fall as you walk alongside patients in the healthcare system. You can make a difference.

The biggest take-home skills:

References:

Brown, B. Dare to lead. United Kingdom, Vermilion, 2018.

Brene, B. Rising Strong. United Kingdom, Vermilion, 2015.

Cheetham, L.JE, Christopher T. Incivility and the clinical learner. Future Healthcare Journal 2020 Vol 7, No 2: 109–11. DOI: 10.7861/fhj.2020-0008

Issa MR, Muslim NA, Alzoubi RH, Jarrar M, Alkahtani MA, Al-Bsheish M, Alumran A, Alomran AK. The Relationship between Emotional Intelligence and Pain Management Awareness among Nurses. Healthcare. 2022; 10(6):1047. https://doi.org/10.3390/healthcare10061047

Rudolph JW, Simon R, Dufresne RL, Raemer DB. There is no such thing as “nonjudgmental” debriefing: a theory and method for debriefing with good judgment. Simul Healthc. 2006 Spring;1(1):49-55. doi: 10.1097/01266021-200600110-00006. PMID: 19088574.

Resources:

https://www.civilitysaveslives.com/

https://brenebrown.com/workbook-art-pics-glossary/

About the authors

  • Erin is a Simulation Nurse Educator for the Douglas Starship Simulation Programme in Auckland New Zealand. She loves designing cutting edge simulation based education programmes. She loves connecting with others & hearing stories, particularly through debriefing. When she isn't doing this she's chasing her two very high energy children or planning elaborate nights out with her husband.

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